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5.
Cureus ; 14(1): e20993, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-35154968

RESUMEN

Hernia repair is one of the most commonly performed surgical operations worldwide. Inguinal hernia is a common condition and has a high prevalence rate. Advanced age and male sex are the most important risk factors. Inguinal hernia usually presents with groin swelling with abdominal discomfort. We report the case of a 39-year-old man who presented to our urologic clinic with a complaint of urinary frequency for the last two months. This was associated with nocturia, feeling of incomplete emptying, and groin swelling. There was no history of hesitancy, intermittency, or weak stream. The patient was otherwise healthy with no significant previous medical or surgical history. Abdominal examination showed a right groin swelling with associated visible and palpable cough impulse in keeping with inguinal hernia. There was no abdominal guarding or rigidity, and the abdomen was non-tender. Examination of the genitalia was unremarkable. No abnormal findings were noted in the examination of other systems. Routine laboratory markers did not show any abnormalities. Urinalysis findings showed no leukocytes and had negative results for leukocyte esterase and nitrites. A computed tomography (CT) scan confirmed the presence of a right-sided inguinal hernia, with part of the urinary bladder seen herniating into the right inguinal canal. The patient underwent a laparoscopic surgery in which the herniated bladder was reduced and the defect was closed with a synthetic mesh. The patient recovered with no complications. Postoperatively, the patient reported significant improvement in his symptoms. Herniation of the bladder through the inguinal canal is an uncommon surgical condition. The case highlighted the importance of considering this diagnosis when they encounter a patient with unexplained lower urinary symptoms. Laparoscopic repair is a feasible and safe option if the surgical team was experienced with this approach.

6.
Cureus ; 13(12): e20118, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-35003961

RESUMEN

Urinary tract infection is a common medical condition encountered in outpatient clinics and emergency departments. Recurrence of urinary tract infections is common. The recurrence can arise from behavioral, mechanical, and physiological factors. Urachal anomalies are very rare congenital clinical entities. We present the case of a 41-year-old woman who presented to the emergency department with dysuria, frequency, urgency, and incontinence. There was no history of fever or flank pain. Physical examination revealed no abnormalities. Initial laboratory markers were within the normal range. However, urinalysis findings showed numerous white blood cells and positive leukocyte esterase and nitrite. While these findings are suggestive of acute simple cystitis, the patient had a concerning history of recurrent urinary tract infections. The urology team advised performing an abdominal computed tomography scan to rule out any structural abnormalities. The patient underwent a computed tomography scan, which demonstrated the presence of a fluid-filled structure arising from the dome of the bladder and extending superiorly toward the umbilicus, representing a vesicourachal diverticulum. The patient underwent surgical resection after antibiotic therapy. The vesicourachal diverticulum is a very rare type of urinary tract anomalies. The case highlights the importance of considering congenital urachal anomalies in patients with recurrent urinary tract infections. A computed tomography scan can make the diagnosis of such anomalies with high accuracy.

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